Strong, consistent evidence shows that managing obesity can delay progression of prediabetes to type 2 diabetes. Obesity management is also highly beneficial in treating type 2 diabetes, based on the degree of weight loss achieved. Losing excess weight improves glycemic control, reduces the need for glucose-lowering medications, can substantially reduce A1C, and can even promote sustained diabetes remission.
Diabesity Clin Diabetes 2022;40(4):392–393 — https://doi.org/10.2337/cd22-0088
Lifestyle
Another Sweet Saturday – 09.17.22
Our 1-year RCT indicated that a lifestyle intervention program can be highly successful in older adults with diabetes and chronic comorbidities. In this specific population, lifestyle intervention not only improved glycemic control associated with improved insulin action and secretion but also improved age-relevant outcomes such as body composition, physical function, and quality of life.
Alessandra Celli, Yoann Barnouin, Bryan Jiang, Dean Blevins, Georgia Colleluori, Sanjay Mediwala, Reina Armamento-Villareal, Clifford Qualls, Dennis T. Villareal; Lifestyle Intervention Strategy to Treat Diabetes in Older Adults: A Randomized Controlled Trial. Diabetes Care 1 September 2022; 45 (9): 1943–1952. https://doi.org/10.2337/dc22-0338
From the periods 1988–1994 to 2017 to March 2020, there was an increase in the prevalence of diagnosed diabetes (from 4.6% to 11.7%), but no change in prevalence of persistent undiagnosed diabetes (from 2.23% to 2.53%) or confirmed undiagnosed diabetes (from 1.10% to 1.23%). Consequently, the proportion of all undiagnosed diabetes cases declined from 32.8% to 17.8% (persistent undiagnosed diabetes) and from 19.3% to 9.5% (confirmed undiagnosed diabetes). Undiagnosed diabetes was more prevalent in older and obese adults, racial/ethnic minorities, and those without health care access. Among persons with diabetes, Asian Americans and those without health care access had the highest proportion of undiagnosed cases, with rates ranging from 23% to 61%.
Michael Fang, Dan Wang, Josef Coresh, Elizabeth Selvin; Undiagnosed Diabetes in U.S. Adults: Prevalence and Trends. Diabetes Care 1 September 2022; 45 (9): 1994–2002. https://doi.org/10.2337/dc22-0242
Remember, Stay as Thin as You Can as Long as You Can.
Stay as Thin as You Can as Long as You Can
Based on the evidence from clinical trials weight loss (typically 15 kg or greater) is the main driver and predictor of remission.
Dietary strategies for remission of type 2 diabetes: A narrative review — https://doi.org/10.1111/jhn.12938
A weight loss program can lead to type 2 diabetes remission, even in individuals with a normal body mass index (BMI), via loss of body fat, particularly in the liver and pancreas, shows a UK study.
Type 2 Diabetes Remission Possible For Those With Lower BMI — https://www.medscape.com/viewarticle/971599?src=rss#vp_1
The title of this post is a direct quote from an Endocrinologist who at the time was practicing in Dallas Texas. I asked if he had any advice for me to reduce my risk of developing diabetes.
“Stay as thin as you can as long as you can.”
These words have stuck with me ever since.

Mothers’ Lifestyle Predicts When Offspring will have First Heart Attack or Stroke
Previous research has shown that parents pass on health to their offspring through both genes and shared environment/lifestyle. This was the first study to examine whether parents’ heart health was associated with the age at which offspring develop cardiovascular disease. In addition, it investigated the influence of each parent separately.
The study was conducted in offspring-mother-father trios from the Framingham Heart Study — a total of 1,989 offspring, 1,989 mothers, and 1,989 fathers. Offspring were enrolled at an average age of 32 years and followed over 46 years (1971-2017) for the development of cardiovascular events. “Crucially, the study followed offspring into most of their adult life when heart attacks and strokes actually occur,” explained Dr. Muchira
European Society of Cardiology. “Mothers’ lifestyle predicts when offspring will have first heart attack or stroke.” ScienceDaily, 4 November 2020. www.sciencedaily.com/releases/2020/11/201104194708.htm.
Journal Reference: Muchira JM, Gona PN, Mogos MF, et al. Parental cardiovascular health predicts time to onset of cardiovascular disease in offspring. Eur J Prev Cardiol., 2020 DOI: 10.1093/eurjpc/zwaa072
Step It Up!
Previous studies have been done on step counts and mortality. However, they were conducted primarily with older adults or among people with debilitating chronic conditions. This study tracked a representative sample of U.S. adults aged 40 and over; approximately 4,800 participants wore accelerometers for up to seven days between 2003 and 2006. The participants were then followed for mortality through 2015 via the National Death Index. The researchers calculated associations between mortality and step number and intensity after adjustment for demographic and behavioral risk factors, body mass index, and health status at the start of the study.
They found that, compared with taking 4,000 steps per day, a number considered to be low for adults, taking 8,000 steps per day was associated with a 51% lower risk for all-cause mortality (or death from all causes). Taking 12,000 steps per day was associated with a 65% lower risk compared with taking 4,000 steps. In contrast, the authors saw no association between step intensity and risk of death after accounting for the total number of steps taken per day.
Higher daily step count linked with lower all-cause mortality
I am so screwed.
Binge Drinkers Bingeing More
The CDC looked at self-reported data from the Behavioral Risk Factor Surveillance System to assess binge-drinking trends from 2011 to 2017.
During this time, the overall prevalence of binge drinking decreased from 18.9% to 18.0%. However, among those who binge drank, the total number of binge drinks consumed annually per adult increased 12%.
LINK(S):
MMWR article (Free)
Anyone surprised?
Optimal Cholesterol Level
The Silent Pandemic
There are no quick-fix solutions, as obesity is not an external problem. It is an internal metabolic issue.
Dr. Rita Nawar Tobias
Interesting article on a weight care clinic in Dubai. This article is worth five minutes of your time.
Even When Not In Rome, Eat A Mediterranean Diet To Cut Heart Disease Risk — Kaiser Health News
Once again, your mother was right. You really do need to eat your vegetables. And while you are at it, put down the bacon and pick up the olive oil, because new research supports the contention that switching to a Mediterranean diet could significantly decrease the risk of heart disease. According to a study published…
via Even When Not In Rome, Eat A Mediterranean Diet To Cut Heart Disease Risk — Kaiser Health News
4 Mistakes Vegans Make About Their Health
Joel Kahn, MD, a Summa Cum Laude graduate of the University of Michigan School of Medicine, is founder of the Kahn Center for Cardiac Longevity and serves as Clinical Professor of Medicine at Wayne State University School of Medicine.
If you want to know what these mistakes are you’ll have to read the full article.
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